Psychologist Sentenced for Health Care Fraud Involving Medicaid

A Wyoming Psychologist has admitted he committed health care fraud by falsely filing Medicaid claims. Gibson Buckley Condie, 57, of Powell, Wyoming has been sentenced to three years in prison and ordered to approximately $2.28 million in restitution, according to Justice.gov.

The Scheme

Condie was a licensed psychologist and pled guilty to making a number of misrepresentations and false statements in an effort to receive Medicaid reimbursements. Officials quoted in the article say that he claimed to be treating patients, but almost all services were provided by unlicensed associates who were not qualified to provide mental health services under Wyoming Medicaid.

He also regularly claimed that a patient had a qualifying mental health disorder by signing off on unregulated mental health assessments. These mental health assessments were often done by people who did not have proper training or licensing to diagnose mental health disorders. As part of the health care fraud, Condie then submitted false bills for these assessments and submitted bills for other treatment services based on these fake and improper assessments.

The psychologist also billed for life skills training, psycho/social rehabilitation, and adult case management services based on these improper assessments. Most of treatment Condie was billing for did not qualify as therapy. Because of the health care fraud, Condie managed to get $2,283,792.49 out of the Wyoming Medicaid system.

Serious Crime

U.S. Attorney Mark Klaassen wants health care operations to realize that fraud is taken seriously by the U.S. government. He is quoted in Justice.gov as saying, “Health care fraud is a serious crime that harms all of us. This criminal activity diverts limited health care resources, driving up costs that affect federal and state budgets and raises premiums.”

He also added that the prison term and monetary penalties imposed in this case should make anyone think twice about committing health care fraud. And he promises that the government will continue to aggressively pursue such cases.

The FBI agrees with the Justice Department, a Special Agent out of Denver hopes that this arrest and conviction sends a “strong message” and aims to stop criminal schemes before they get started. Multiple agencies were involved in the investigation of Gibson and all hope to deter health care fraud, especially where Medicaid is concerned.

“Serving as a Medicaid provider is a privilege, which carries the responsibility to account for taxpayer money with honesty and transparency,” said Travis J. Kirchhefer, Senior Assistant Attorney General and Director of the Wyoming Office of Attorney General’s Medicaid Fraud Control Unit.